HomeMy WebLinkAbout2513 VIA SORBETE; ; CB890550; PermitfJJ z 0 ;:::
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0 I hereby affirm that I am licensed under
p,ovlalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profaaalona Code, and my license is In
full force and effect.
I hereby aUum Iha! 1 am exempt lrom ll'le Contrac
tor·s License Law tor the l0Uow1ng reason (Sec 7031 5
Business and Prolessioos Code Any city Of counly whtet. re-
quires a perm11 to construct a!ler improve demolish. Of
reoair any slruclure. prior 1011s issuance also requires !heap-
phcan1 for such perm11 to tile , s.tQned statement thal he ,s
ltcensea pursuant to the prov1s1ons ot !he Umuact0< s
license law (Chapter 9 commencmg w11ri Section 7000 of
Oiv1st0n 3 oC the Business and Protesst0ns Code) or thal ,sex
empt lherelrom and lht basis IOf the aUegea exempl!On Any vtOtat,on ol Secoon 7031 5 by an apphcant tor a permit suD·
1ec1s rhe applicant 10 a CIVIi penally ol not mo(t lhan ltve hun-ar..i Oollars ($500)
I, as owner of lhe property. Of my employees w!lh wages
as !heir sole compensahon will do the work_ ano the strut·
lure 1s nol intended or oflered for saJe (Sec 7044, Business
and Proless10t1s. Code The Contractor's Lttense Law does
not apply 10 an owner ol property who builds or improves
!hereon and who does such work h1msell or lhrough hes own
emotoyees. provided lhal such 1mprovemenls are no1 intend• ed or offered ICM" sale II however lhe building Of tmprove-
ment 1s SOid within one year ol complehon. the owneH>u1lder
will n.ave the burden o1 proving that he did not build o, 1m•
prove !or lhe purpose ot sale)
I. as owner ol lhe property. am exclusively contracung
w1th hcensed contraclors to consrrucl the proiecl (Sec 7044,
Busmess and Profess«ms Code The Conlraclor"s UCense
law does not apply to an owner of property who blukjs or im-proves thereon. anct who conuacts for each proiec1s w11h a
contractor(s) license pursuant to lhe Contraclor's l1tense Law)
,-As a homeowner I am 1mprov,ng my hOme. and the lollow
1ng cond111ons exist
1 The work 1s bemg performed poor to sa1e
2 I have hved m my home for twelve months
prior to complehon of ltus work
I have not claimed ttllS exemption during the
last three yea,s
□ I am exempt under Sec ______ . 8 & P C
for this reason -------------
....... I hereby alfum that I have a cert1hcate ot consent to
self•tnsure. or a cerl1fica1e of Worl(ers Compensallon In•
surance. or a certified copy !hereof 1Sec 3800. Labor Code)
POLICY NO
COMPANY
::J Copy ,s hied w1Ht the c1ly
::J Cert1fted copy 15 hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS. COMPENSATION INSURANCE
(This sec11on need not t>e comple1ed 1t the perm11
is tor one hundred dollars (SH)O) Of less)
:J I cert,ty thal in the performance of the work tor which
this permit is issued. I shall not employ any person many
manner so as 10 become subJect lo the Workers Compen•
sauon Laws of Calilorma
NOTICE TO APPLICANT If, after making this Cerhftcate
of Exemption. you should become sub1ect to lhe Workers
Compensation Pf0111s1ons of the Labo, Code. you must
forthwith comply with such pro11is1ons or this perm+t shall
be deemed reYOked.
0 I hereby affirm that there is a conslructton lending
agency for the performance of !he wotk for wtuch 1h1s per•
m11 is issued (Sec 3097, C1vH Code)
lender's Name ____________ _
Lenders Address. ___________ _
USE BALL POINT PEN ONLY & PRE~S HARO --·----APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161
JOB ADDRESS AV. ST. RO. THOMAS BROS NO.
r~:,;~~TION1
BUSINESS LICENSE • VALUATION PERMIT NUMBER
~/3 V1Pt Sor-be.k
LOT BLOCK I SUBDIVISION I ASSESSOR PARCEL NO CONTRACTOR CONTRACTORS PHONE• ZONE C ~ 69tJ5§'CJ
OWNER'S NAME I OWNER'S PHONE Pr-.._ tr\ 0 l'V'\..o "°' ~ l \rnr)\ r--r-.. (' l'\ 7 d-7-70'1(J
µ,,cl-en:) \.u & \ he('" CONT~TOR'S ~RESS -..j STA TE LICENSE NO. BUILDING SO. FOOTAGE
~\ 5 -~rtt"Q~Ave.,Si~-t>f L-l~ddL!l OWNER'S MA LING ADDRESS
.?.loQL4 £\ ~,nD ~~, ' ~l)\-\-~ ~ OES<GNER DESIGNER'S PHONE
OESCRIPTrON OF WORK \
T ~ ;...:,y" ~<.. 'inl OESIGNER·s ADDRESS STATE LICENSE NO.
' _] 6119 04/12/89 0001 01 02
F,P FLA ELEV. NO ace GP EDU BldPmt 10.oc STORIES
vO NO I CENSUS TRACT I PARKING SPACE RES UNITS I GRACING PE.AMIT ISSUED I RED EVELOPMENT TYPE ace LOAD Fl RE SPA
AREA CONST
y D ND vO NO vO NO Not Valid Unlns Machin, Cuttli«J
QTY. PLUMBING PERMIT · ISSUE 1 .--50 QTY. MECHANICAL PERMIT · ISSUE /Se;o SUMMARVACCOUNTNUMBER
EACH FIXTURE TRAP INSTALL FURN DUCTS UP TO 100 000 BTU BUILDING ~tHMIT 001 ·81 O·OO·OO·ijUU
EACH BUILDING SEWER OVER 100.000 BTU SIGN PERMIT 001·810·00·00·8221
EACH WATER HEATE R ANO OR VENT BOILER1COMPRESSOR UP 10 3 HP PLAN CHECK 001·810·00·00·8891
I EACH GAS SYSTEM I TO 4 OUTLETS BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING OOi ·810·00·00·8222
EACH GAS SYSTEM ~ OR MORE METAL FIREPLACE ELECTRICAL 001·810·00·00·8223
EACH INSTAL . ALTER. REPAIR WAT ER PIPE VENT FAN SINGLE DUCT MECHANICAL 001·810·00·00·8224
EACH VACUUM BREAKER ME CHE XHAUST HOOO OUCTS MOBILEHOME 001·810·00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE IHEA TE R SOLAR 001 ·810·00·00·8226
EACH ROOF DRAIN !INSIDE I DRYER VENT STRONG MOTION 880·519·92·33
TOT!.L MECHANICAL FIRE SPRINKLERS 001·810·00·00·8227
TO I AL PLUMBING I /() .,.. PUBLIC FACILITIES FEE 320·810·00·00·87 40
-~tJO
BRIDGE FEE 360-810·00·00·8740
QTY. ELECTRICAL PERMIT • ISSUE QTY. MOBILE HOME SETUP PARK·IN·LIEU (AREA )
NEW CONST EA AMP SWT !!KR CAR PORT TIF 312·810·00·00·8835
I PH 3 PH AWNING LA COSTA TIF 311·810·00·00·8835
EXIST !!LOG EA AMP SWT 8KR GARAGE FMF
l PH 3 PH LICENSE TAX 001·810·00·00·8162
REMODEL Al TtR PER CIRCUll MFF 880·519·92·57
TEMP POLE 700 AMPS
OVE A 200 AMPS
TEMP OCCUPANCY !30 DAYSI
CREDIT DEPOSIT
TOTAL ELEtTRICAL l 1/::e; TOT Al TOTAL FEES PAYABLE l 10---
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT ANO 00 HEREBY Exp,rahon Every permit issued by the 8u,ldtng Olf1c11f under lh-e provisions of lh1s * AN OSHA PE!W..:T IS REQUIAEO FOfl EXCAVATIONS OVER
CERTIFY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exptre by hm1tat1on and become null and void If the building or work s· 0 DEEP ANO DEMOLITIOH Ofl CONSTRUCTION OF
DECLARATIONS ARE TRUE ANO CORRECT ANO I FURTHER CERTIFY AND AGREE IF A PERMIT I!, authorized by such permit 1s not commenced within 180 days from lhf' date ot sucn STRUCTURES OYER 3 STORtES IN HEIGHT
ISSUED TO COMPLY WITH ALL CITY COUNlY AND STATE LAWS GOVERNING BUILDING CON ::~~
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STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO APPLICANT'S SIGNATURE If, OWNERn CONTRACTOR 0 APPROVE~, ~ 0:/l.iTE 1 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All LIABILITIES, JUDGMENTS. COSTS ANO
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE
&11 .N\ ~ J) LC..b-nSCY1 BV PHONE [J GRANTING OF THIS PERMIT I '//)_,,~ --
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TYPE DATE INSPECTOR
BUILDING
FOUNDATION ••
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
SUB FRAME D FLOOR D CEILING
SHEATHING □ ROOF □ SHEAR
FRAME
EXTERIOR LA TH
INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
D SEWER AND BUCO D PUCO
UNDERGROUND □ WASTE □ WATER
TOP OUT □ WASTE □ WATER
TUB AND SHOWER PAN
GAS TEST
□ WATER HEATER □ SOLAR WATER
ELECTRICAL
□ ELECTRIC UNDERGROUND □ UFFER
ROUGH ELECTRIC
□ ELECTRIC SERVICE □ TEMPORARY
□ BONDING □ POOL
MECHANICAL
□ DUCT & PLEM., □ REF. PIPING
HEAT -AIR COND. SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APP_R_O_vEO. ___ _
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
~~6'"~
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTORS DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING I
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
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